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Abstract Background Pisum sativum (PS) is a universal legume plant utilized for both human and animal consumption, particularly its seeds, known as green peas. The processing of PS in food industries and households produces a significant amount of waste that needs to be valorized. Methods In this study, the metabolite profiles of the 70% ethanolic extracts of PS wastes, namely peels (PSP) and a combination of leaves and stems (PSLS), were investigated by liquid chromatography-electrospray ionization-quadrupole time-of-flight tandem mass spectrometry (LC-ESI-QTOF-MS/MS) followed by molecular networking. Results Different classes of metabolites were identified, being flavonoids and their derivatives, along with phenolic acids, the most abundant categories. Additionally, a comprehensive network pharmacology strategy was applied to elucidate potentially active metabolites, key targets, and the pathways involved in cytotoxic activity against breast cancer. This cytotoxic activity was investigated in MCF-7 and MCF-10a cell lines. Results revealed that PSLS extract exhibited a potent cytotoxic activity with a good selectivity index (IC50 = 17.67 and selectivity index of 3.51), compared to the reference drug doxorubicin (IC50 = 2.69 µg/mL and selectivity index of 5.28). Whereas PSP extract appeared to be less potent and selective (IC50 = 32.92 µg/mL and selectivity index of 1.62). A similar performance was also observed for several polyphenolics isolated from the PSLS extract, including methyl cis p-coumarate, trans p-coumaric acid, and liquiritigenin/ 7-methyl liquiritigenin mixture. Methyl cis p-coumarate showed the most potent cytotoxic activity against MCF-7 cell line and the highest selectivity (IC50 = 1.18 µg/mL (6.91 µM) and selectivity index of 27.42). The network pharmacology study revealed that the isolated compounds could interact with several breast cancer-associated protein targets including carbonic anhydrases 1, 2, 4, 9, and 12, as well as aldo-keto reductase family 1 member B1, adenosine A3 receptor, protein tyrosine phosphatase non-receptor type 1, and estrogen receptor 2. Conclusion The uncovered therapeutic potential of PSLS and its metabolite constituents pave the way for an efficient and mindful PS waste valorization, calling for further in-vitro and in-vivo research. Graphical Abstract

Abstract Background Lateral ankle sprains rank among the most prevalent musculoskeletal injuries, while chronic ankle instability (CAI) is its most common cascade. In addition to the conflicting results of the previous studies and their methodological flaws, the specific gait loading strategy is still not well studied. Purpose The study aimed to investigate the fluctuations in gait loading strategy in people with chronic ankle instability compared to health control. Methods A total of 56 male subjects participated in this study and were allocated into two groups: (A) CAI group: 28 subjects with unilateral CAI (age 24.79 ± 2.64 and BMI 26.25 ± 3.50); and (B) control group: 28 subjects without a history of ankle sprains (age 24.57 ± 1.17 and BMI 26.46 ± 2.597). Stance time, weight acceptance time, and load distribution were measured to investigate gait loading strategy. Results The study findings revealed that the CAI group had a significant higher load over the lateral rearfoot. However, MANOVA indicates that there was no overall significant difference in gait loading strategy between the CAI and control groups. Furthermore, in terms of stance time, time of weight acceptance phase, load over medial foot, and load over lateral foot, CAI and healthy controls seemed to walk similarly. Conclusions The findings revealed that individuals with CAI had the significant alteration in the lateral rearfoot loading, suggesting a potential compensatory mechanism to address instability during the weight acceptance phase. This could manifest a laterally deviated center of pressure and increased frontal plane inversion during the early stance phase. However, it is acknowledged that these alterations could be both the result and the origin of CAI. The study highlights the vulnerability of CAI during the early stance phase, emphasizing the need for gait reeducation as individuals return to walking as healthcare clinicians should focus on treatment modalities aimed at reducing rearfoot inversion in individuals with CAI.

Abstract Limited solubility is the main cause of the low local availability of anti-candidiasis drug, miconazole nitrate (MN). The study’s objective was to develop and characterize microemulsion (ME) based temperature-triggered in situ gel of MN for intravaginal administration to enhance local availability and antifungal activity. The solubility of MN was initially studied in different oils, surfactants, and co-surfactants. Then, pseudo-ternary phase diagrams were constructed to select the best ratio of various components. The ME formulations were characterized by thermodynamic study, droplet size, polydispersity index (PDI), viscosity, and in-vitro antifungal mean inhibition zone (MIZ). Selected MEs were incorporated into different in situ gel bases using a combination of two thermosensitive polymers (poloxamer (PLX) 407 and 188), with 0.6% of hydroxypropyl methylcellulose (HPMC K4M) and gellan gum (GG) as mucoadhesive polymer. ME-based gels (MG) were investigated for gelation temperature, gelation time, viscosity, spreadability, mucoadhesive strength, in vitro release profile, and MIZ test. Furthermore, the optimum MG was assessed for in vivo animal irritation test and FESEM investigation. Tea tree oil, lavender oil, tween 80, and propylene glycol (PG) were chosen for ME preparation for the optimal formulation; formulation ME7 and ME10 were chosen. After incorporation of the selected formulation into a mixture of P407 and P188 (18:2% w/w) with 0.6% mucoadhesive polymer, the resultant MG formulation (MG1) revealed optimum gelation temperature (33 ± 0.01℃) and appropriate viscosity with enhanced sustained release (98%) and retention through sheep vaginal mucosa, MG1 exhibited a better MIZ compared to the 2% MN gel formulation and the marketed MN product, and no rabbit vagina irritation. In conclusion, the miconazole nitrate-loaded MG-based formula sustained the duration of action and better antifungal activity than the marketed miconazole nitrate formulation.

Background: Online resources are becoming the primary educational resource for patients. Quality and reliability of websites about coronary artery bypass graft (CABG) procedures are unknown. Methods: We queried 4 search engines (Google, Bing, Yahoo!, and Dogpile) for the terms coronary artery bypass, coronary artery bypass graft, coronary artery bypass graft surgery, and CABG. The top 30 websites from each were aggregated. After exclusions, 85 websites were graded with the DISCERN instrument, patient-focused criteria, and readability calculators by a 2-reviewer system. Results: Accessibility was low; 34.1% of websites disclosed authorship, and 23.5% were available in Spanish. Median total score was 55 of 95 (interquartile range [IQR], 44-68); this score varied by website type (P = .048). Professional medical society (median, 76; IQR, 76-76) and governmental agency (median, 69; IQR, 56.6-75.5) scored higher, whereas industry (median, 51.8; IQR, 47.1-56.4) and hospital/health care (median, 49; IQR, 40-61) scored lower. Readability was low, with median Flesch-Kincaid grade level score of 11.1 (IQR, 9.5-12.6) and 75.3% of websites written above eighth-grade reading level. Conclusions: Accessibility of online patient educational resources for CABG procedures is limited by language and reading level despite being widely available. Quality and reliability of the information offered varied between website types. Improving readability to ensure patients’ understanding and comprehensive decision-making should be prioritized.

Robotic assisted partial nephrectomy is the gold standard treatment for small renal masses. Ureteric stricture is a rare but serious complication that significantly increase the morbidity and worsens the quality of life for cancer patients. Definitive treatment such as surgical reconstruction or ureteroureterostomy is not always feasible as in patients with significant morbidity or high-risk patients. Other options include ureteric double J stent or nephrostomy tube placement with regular exchange. We present a case of iatrogenic upper ureteric stricture post robotic assisted partial nephrectomy for right renal mass that was discovered on postoperative follow up imaging treated with metallic ureteral stent (Memokath) as reconstructive surgery was difficult due to proximity to the tumor bed. We found that if reconstructive surgery is not feasible, metallic ureteral stents has good durability, better quality of life than ureteric double stents for the management of ureteric stricture.

Moderate or severe aortic insufficiency is a contraindication to transvalvular Impella left ventricular assist device (Abiomed) use out of concern for worsening valvular insufficiency and recirculation. This report describes the case of a 75-year-old man with severe eccentric aortic insufficiency and systemic hypoperfusion who was supported with a transvalvular Impella 5.5 device for 6 days as preoperative rehabilitation before aortic valve replacement. The Impella device provided adequate systemic tissue perfusion, and left ventricular function remained without signs of volume overload and recirculation. Moderate or severe aortic insufficiency may not be an absolute contraindication to transvalvular Impella use, although this is case dependent.

Background: Type I diabetes mellitus (T1DM) is one of the most common chronic autoimmune diseases worldwide. miRNAs are a class of small non-coding RNA molecules that have been linked to immune system functions, β-cell metabolism, proliferation, and death, all of which contribute to pathogenesis of TIDM. Dysregulated miRNAs have been identified in Egyptian TIDM patients. Aim: Several miRNAs were profiled in Egyptian TIDM patients to determine whether they can be used as molecular biomarkers for T1DM. The relationship between the investigated miRNAs and pro-inflammatory cytokines (TNF-α and IL-6) has also been evaluated in the development of TIDM, in addition to the creation of a proposed model for TIDM prediction. Patients & methods: Case-control study included 177 Egyptian patients with confirmed type I diabetes mellitus and 177 healthy individuals. MiRNA-34 and miRNA-146 were detected in serum samples using real-time PCR, whereas TNF-α and IL-6 levels were assessed using ELIZA. Results: Patients with TIDM showed a significant decrease in the expression of miRNA-146, with a cut-off value ≤ 3.3, 48 % specificity, and 92.1 % sensitivity, whereas miRNA-34 had the highest sensitivity (95.5 %) and specificity (97.2 %) for differentiating diabetic patients from controls. Furthermore, other diagnostic proinflammatory markers showed lower sensitivity and specificity. Conclusion: Serum levels of miRNA-34a, miRNA-146, IL-6, and TNF-α provide new insights into T1DM pathogenesis and could be used for screening and diagnosis purposes. They can be also a potential therapeutic target, as well as allowing for more strategies to improve T1DM disease outcomes.

Abstract This study investigates the differential responses of two maize genotypes, SC180 and SC168, to salt stress, aiming to elucidate the mechanisms underlying salinity tolerance and identify traits associated with improved stress resilience. Salinity stress, imposed by 150 mM NaCl, adversely affected various growth parameters in both genotypes. SC180 exhibited a more pronounced reduction in shoot length (13.6%) and root length (13.6%) compared to SC168, which showed minimal reductions (3.0% and 2.3%, respectively). Additionally, dry weight losses in SC180's leaves, stems, and roots were significantly greater than those in SC168. Under salinity stress, both genotypes accumulated Na+ in all organs, with SC168 showing higher Na + concentrations. However, K+ levels decreased more significantly in SC180's leaves than in SC168's. The study also assessed physiological responses, noting that SC180 experienced a substantial reduction in relative water content (RWC) in leaves (22.7%), while SC168's RWC remained relatively stable (5.15%). Proline accumulation, a marker for osmotic adjustment, increased 2.3-fold in SC168 compared onefold in SC180. Oxidative stress indicators, such as electrolyte leakage and hydrogen peroxide levels, were elevated in both genotypes under salt stress, with SC180 showing higher increases (48.5% and 48.7%, respectively) than SC168 (35.25% and 22.0%). Moreover, antioxidant enzymes (APX, CAT, POD, SOD, GR) activities were significantly enhanced in SC168 under salinity stress, whereas SC180 showed no significant changes in these activities. Stress indices, used to quantify and compare salinity tolerance, consistently ranked SC168 as more tolerant (average rank = 1.08) compared to SC180 (average rank = 1.92). Correlation analyses further confirmed that SC168's superior tolerance was associated with better Na + regulation, maintenance of K+ levels, and a robust antioxidant defense system. In conclusion, SC168 demonstrated greater resilience to salinity stress, attributed to its efficient ion regulation, stable water status, enhanced osmotic adjustment, and strong antioxidant response. These findings provide valuable insights for breeding and developing salinity-tolerant maize varieties.

Abstract Background Tobacco mosaic virus (TMV) is a highly infectious plant virus that affects a wide variety of plants and reduces crop yields around the world. Here, we assessed the effectiveness of using Ammi visnaga aqueous seed extract to synthesize silver nanoparticles (Ag-NPs) and their potential to combat TMV. Different techniques were used to characterize Ag-NPs, such as scanning and transmission electron microscopy (SEM, TEM), energy-dispersive X-ray spectroscopy (EDS), fourier transform infrared spectroscopy (FTIR), and dynamic light scattering (DLS). Results TEM demonstrated that the synthesized Ag-NPs had a spherical form with an average size of 23–30 nm and a zeta potential value of -15.9 mV, while FTIR revealed various functional groups involved in Ag-NP stability and capping. Interestingly, the Pre-treatment of tobacco plants (protective treatment) with Ag-NPs at 100–500 µg/mL significantly suppressed viral symptoms, while the Post-treatment (curative treatment) delayed their appearance. Furthermore, protective and curative treatments significantly increased chlorophyll a and b, total flavonoids, total soluble carbohydrates, and antioxidant enzymes activity (PPO, POX and CAT). Simultaneously, the application of Ag-NPs resulted in a decrease in levels of oxidative stress markers (H2O2 and MDA). The RT-qPCR results and volcano plot analysis showed that the Ag-NPs treatments trigger and regulate the transcription of ten defense-related genes (SbWRKY-1, SbWRKY-2, JERF-3, GST-1, POD, PR-1, PR-2, PR-12, PAL-1, and HQT-1). The heatmap revealed that GST-1, the primary gene involved in anthocyanidin production, was consistently the most expressed gene across all treatments throughout the study. Analysis of the gene co-expression network revealed that SbWRKY-19 was the most central gene among the studied genes, followed by PR-12 and PR-2. Conclusions Overall, the reported antiviral properties (protective and/or curative) of biosynthesized Ag-NPs against TMV lead us to recommend using Ag-NPs as a simple, stable, and eco-friendly agent in developing pest management programs against plant viral infections.

Abstract Sitosterolemia is a rare inherited disorder caused by mutations in the ABCG5/ABCG8 genes. These genes encode proteins involved in the transport of plant sterols. Mutations in these genes lead to decreased excretion of phytosterols, which can accumulate in the body and lead to a variety of health problems, including premature coronary artery disease. We conducted the first genome-wide association study (GWAS) in the Middle East/North Africa population to identify genetic determinants of plant sterol levels in Qatari people. GWAS was performed on serum levels of β-sitosterol and campesterol using the Metabolon platform from Qatar Biobank (QBB) and genome sequence data provided by Qatar Genome Program. A trans-ancestry meta-analysis of data from our Qatari cohort with summary statistics from a previously published large cohort (9758 subjects) of European ancestry was conducted. Using conditional analysis, we identified two independent single nucleotide polymorphisms associated with β-sitosterol (rs145164937 and rs4299376), and two others with campesterol (rs7598542 and rs75901165) in the Qatari population in addition to previously reported variants. All of them map to the ABCG5/8 locus except rs75901165 which is located within the Intraflagellar Transport 43 (IFT43) gene. The meta-analysis replicated most of the reported variants, and our study provided significant support for the association of variants in SCARB1 and ABO with sitosterolemia. Evaluation of a polygenic risk score devised from European GWAS data showed moderate performance when applied to QBB (adjusted-R2 = 0.082). These findings provide new insights into the genetic architecture of phytosterol metabolism while showing the importance including under-represented populations in future GWAS studies.

Abstract Invasive fungal infections (IFI) pose a significant health burden, leading to high morbidity, mortality, and treatment costs. This study aims to develop and characterize nanomicelles for the codelivery of posaconazole and hemp seed oil for IFI via the oral route. The nanomicelles were prepared using a nanoprecipitation method and optimized through the Box Behnken design. The optimized nanomicelles resulted in satisfactory results for zeta potential, size, PDI, entrapment efficiency, TEM, and stability studies. FTIR and DSC results confirm the compatibility and amorphous state of the prepared nanomicelles. Confocal laser scanning microscopy showed that the optimized nanomicelles penetrated the tissue more deeply (44.9µm) than the suspension (25µm). The drug-loaded nanomicelles exhibited sustained cumulative drug release of 95.48 ± 3.27% for 24 h. The nanomicelles showed significant inhibition against Aspergillus niger and Candida albicans (22.4 ± 0.21 and 32.2 ± 0.46 mm, respectively). The pharmacokinetic study on Wistar rats exhibited a 1.8-fold increase in relative bioavailability for the nanomicelles compared to the suspension. These results confirm their therapeutic efficacy and lay the groundwork for future research and clinical applications, providing a promising synergistic antifungal nanomicelles approach for treating IFIs.

Abstract Introduction The wrist joint is a complex anatomical structure, and various radiographic parameters are utilized to assess its normal alignment and orientation. Among these parameters are carpal height ratio (CHR) and ulnar variance (UV). Previous literature has indicated that factors such as age and gender may influence these parameters; However, there is a lack of studies investigating these differences specifically in the Middle East or Jordan. Additionally, no prior research has explored the relationship between UV and CHR. Therefore, the objective of this study is to investigate these critical radiological parameters and their associations. Methodology A cross-sectional study design was employed, wherein a total of 385 normal wrist X-rays were reviewed, and CHR and UV were measured. Intra-observer and inter-observer reliability assessments were conducted to ensure the consistency and accuracy of measurements. Additionally, the association between UV and CHR was measured and plotted for further analysis. Results In our study, the mean CHR was 0.5 (range: 0.4 to 1.5), and the mean UV was − 0.3 mm (range: -5.8 mm to 4.1 mm). We found a significant negative correlation between CHR and age (p

The research was planned to evaluate the ability of an omental pedicle flap with platelets-rich fibrin (PRF) to augment bladder defects in dogs. Eighteen adult- male dogs were used. After general anesthesia, a partial cystectomy with a circular shape with a diameter of 3cm. was performed on the dorsal surface of the bladder. Then, the animals (N=9) were divided into two equal groups. In the first group, the bladder defect was closed with a double layer of omentum. In contrast, in the second group, the defect was also reconstructed by a double layer of omentum with topical application of platelets-rich fibrin between both layers. The results were evaluated by studying the gross, cystography, and histopathological changes on 7, 15, and 30 days postoperatively. Monitoring of clinical signs with statistical histopathological scoring analysis was also studied. The clinical signs during the first-week post-operation were represented by loss of appetite, straining during urination, and hematuria. These signs disappeared after the first week of surgical repair, and all animals ultimately returned to their normal body status. The complete closure of the bladder defect represented the gross changes. The histopathological results represented the formation of granulation tissue, angiogenesis, and infiltration of polymorphonuclear and mononuclear inflammatory cells in both groups. The proliferation and maturation of granulation tissue were more in the second group, in addition to lower degree of inflammatory cell infiltration. The results of cystography revealed no sign of urine leakage. In conclusion, adding PRF to omentum can improve the healing of bladder defects in dogs.

This paper presents a novel approach for measuring multi-shapes degrees of similarities. A new shape transformation concept is suggested through mapping the closed boundary of the shape using unfolded process into one-to-one equivalent graph (or signal) where ample number of approaches for similarity testing can be applied. The degree of similarity is then measured by calculating the discrepancies between each of the two transformed unfolded-graphs autocorrelation functions. The proposed method is also effective in applying clustering technique for clustering groups of shapes into three hierarchical similarity levels depending on their mutual degree of similarity. The suggested similarity method handles two categories of shapes: geometric and non-geometric. Unlike other well-known techniques in the subject of machine learning and deep learning, the presented method represents a powerful analytical-based technique for similarity analysis of both regular and irregular shapes regardless of size or orientation, and in effectively handling compound or multi-shapes degrees of similarities. The results of testing the approach on selected datasets have successfully demonstrated the great effectiveness of the developed technique in yielding output multi-shape degrees of similarities in new graphical and comprehensive forms. Finally, it is pointed out that the new approach will have many potential real-life applications such as in industry, medicine, biology, security, and authentications.

الملخص: أهداف البحث: استكشاف وفهم التحول في نظام الرعاية الصحية في المملكة العربية السعودية، والتغييرات والتحديات المحتملة، وتأثيراتها على أصحاب المصلحة الرئيسيين. طرق البحث: للحصول على رؤى متعمقة حول وجهات نظر قادة الرعاية الصحية فيما يتعلق بالتحول في نظام الرعاية الصحية في المملكة العربية السعودية، تم استخدام نهج البحث النوعي. تم اختيار عشرة مشاركين من خلفيات متنوعة، يمثلون مختلف القطاعات في المملكة العربية السعودية: القطاع الخاص، العام، التنفيذي، الاستشاري، والتنظيمي. أجريت هذه الدراسة في الفترة ما بين أغسطس 2022 ويونيو 2023. النتائج: كشفت النتائج عن أربعة محاور رئيسية تلقي الضوء على تحول نظام الرعاية الصحية في المملكة العربية السعودية وآثاره: إصلاح نظام الرعاية الصحية، وتأثير الخصخصة/المأسسة على مقدمي الرعاية الصحية، وتأثير الخصخصة/المأسسة على التأمين الصحي، وتأثير الخصخصة/المأسسة على القوى العاملة. علاوة على ذلك، أشارت النتائج إلى أن التحول المستمر للقطاع العام نحو الخصخصة في المملكة العربية السعودية يواجه تحديات مختلفة تؤثر على معظم، إن لم يكن جميع، أصحاب المصلحة في هذا القطاع. ومع ذلك، يمتلك القطاع الخاص العديد من نقاط القوة التي يمكن أن تساعد في مواجهة التحديات المرتبطة بالتحول السريع للنظام. تشمل نقاط القوة هذه الإلمام بالسوق، والإدارة المالية القوية، والخبرة الواسعة في البرمجة وإعداد الفواتير لدافعي التأمين وشركات التأمين، وعمليات اتخاذ القرار الفعالة، والمرونة، والنضج. الاستنتاجات: سهلت الدراسة الحصول على رؤى شاملة حول تحول نظام الرعاية الصحية في المملكة العربية السعودية وتحول القطاع العام نحو التحول إلى شركات/الخصخصة. ويجب على القطاع تعزيز قدراته من خلال إنشاء وحدات متخصصة وتوظيف المواهب. هناك حاجة أيضا إلى مزيد من الدراسات للحصول على فهم أعمق للعقبات التي تعوق التحول. Abstract: Objectives: To explore and understand KSA’s fundamental healthcare system reform, the potential changes and challenges, and their impacts on major stakeholders. Methodology: To gain in-depth insights into healthcare leaders’ perspectives regarding healthcare system reform in KSA, a qualitative research approach was used. Ten participants from diverse backgrounds were selected, representing various sectors in KSA: private, public, executive, consulting, and regulatory. This study was conducted between august 2022 and June 2023. Findings: The findings revealed four key themes that shed light on healthcare system transformation in KSA and its effects: healthcare system reform, the impact of corporatization/privatization on healthcare providers, the impact of corporatization/privatization on health insurance, and the impact of corporatization/privatization on the workforce. Furthermore, the findings indicated that the ongoing transformation of the public sector toward privatization in KSA faces various challenges that affect most, if not all, stakeholders in the sector. However, the private sector possesses several strengths that can aid in addressing the challenges associated with the rapid transformation of the system. These strengths include familiarity with the market, robust financial management, extensive experience in coding and billing payers and insurance companies, efficient decision-making processes, flexibility, and maturity. Conclusion: The study facilitated comprehensive insights into the transformation of KSA’s healthcare system and the public sector’s shift toward corporatization/privatization. The sector must enhance its capabilities by establishing specialized units and recruiting talent. Further studies are also needed to gain a deeper understanding of the obstacles hindering the transformation.

In this study, the potential implementation of three different low-GWP refrigerants (R32, R452B, and R454B) as replacements for R410A was investigated. The study was performed using a simulation tool developed by the authors called RACHP-Lab, which is a vapor compression system simulation tool developed based on physics-based simulation for typical mini-split air conditioners. The simulation study was carried out and validated using experimental performance data of 10 different air conditioning units available in the Egyptian market. The units included fixed-speed or variable-speed compressors and operated in cooling or heating modes. Drop-in replacement with the new refrigerants was carried out. For R32, the capacity increased between 4.9% and 13% for cooling cases, and 6.3% and 12.4% for heating cases. However, COP did not improve in all cases. For R452B and R454B with direct replacement, the capacity nearly remained the same, with an increase of COP between 1.6% and 8.0%. Soft optimization was also conducted on cooling cases where compressor suction superheat, condenser subcooling, and compressor volumetric speed were optimized to maximize COP while maintaining the original capacity of R410A. R32 showed an improvement of COP over R410A between 4.6% and 15.5%, while for R452B and R454B between 2.2% and 13.2%.

Maize stands out as a versatile commodity, finding applications in food and animal feed industries. Notably, half of the total demand for maize is met through its utilization as animal feed. Despite its importance, maize cultivation often grapples with crop failures resulting from delayed disease management or insufficient knowledge about these diseases, impeding timely intervention. The advent of technological advancements, particularly in Machine Learning, presents solutions to address these challenges. This research focuses on employing a Convolutional Neural Network (CNN) to classify maize plant diseases. Two datasets form the foundation of this study. The first dataset encompasses 4144 images distributed across 4 classes, while the second dataset comprises 5155 images distributed among 7 to 8 classes. The second dataset encounters issues related to imbalanced class distribution, where certain classes possess substantially more data than others. To mitigate this imbalance, the weighted cross-entropy loss method is employed. During experimentation, three distinct architectural models—ResNet-18, VGG16, and EfficientNet—are rigorously tested. Additionally, various optimizers are explored, with noteworthy results indicating that both datasets achieve peak accuracy through the use of the SGD (Stochastic Gradient Descent) optimization. For the first dataset, optimal results are obtained with the VGG16 architecture, leveraging a frozen layer in the classification stage and achieving an impressive accuracy of 97.146 %. Shifting the focus to the second dataset, the most favorable outcome is realized by employing the EfficientNet architecture without a frozen layer, coupled with the implementation of weighted loss to address the class imbalance, resulting in an accuracy of 94.798 %.

BackgroundWith the increasing global prevalence of type 2 diabetes (T2D) and obesity, there is a pressing need for novel therapeutic interventions. Lavandula stoechas, a medicinal plant traditionally used for various ailments, holds promise as a potential agent for T2D management, particularly in Morocco, where it is commonly used to treat diabetes. This study aims to evaluate the pharmacological potential of L. stoechas aqueous extract (AqLs) by assessing its lipase inhibition antioxidant and anti-inflammatory activities, identifying phenolic compounds, and examining its efficacy in reducing diabetic complications.MethodsThe pharmacological potential of L. stoechas aqueous extract was investigated using in vitro assays. The inhibitory effect on pancreatic lipase, antioxidant power (FRAP), and anti-inflammatory activity (albumin denaturation method) was assessed. High-performance liquid chromatography (HPLC) analysis identified phenolic compounds. Additionally, albumin glycation was evaluated by estimating fructosamine, carbonyl groups, and amyloid β-structures to assess efficacy in mitigating diabetic complications.ResultsThe extract demonstrated concentration-dependent inhibition of pancreatic lipase (IC50 = 0.132 ± 0.006 mg/mL), potent antioxidant activity (IC50 = 604.99 ± 1.01 μg/mL), and dose-dependent anti-inflammatory effects (IC50 = 207.01 ± 34.94 mg/mL). HPLC analysis revealed phenolic compounds: naringin (38.28%), syringic acid (25.72%), and cinnamic acid (15.88%) were the most abundant, with 4-hydroxybenzoic acid, hydrated catechin, and catechin ranging from 9.60% to 5.24%, and p-coumaric acid (1.73%). Furthermore, the extract inhibited albumin glycation and fructosamine production, suggesting efficacy in mitigating diabetic complications.ConclusionThese findings highlight the multifaceted pharmacological potential of L. stoechas aqueous extract in T2D management, suggesting that this plant can be highly beneficial for diabetic individuals.

Abstract Artificial intelligence (AI) seismology has witnessed enormous success in a variety of fields, especially in earthquake detection and P and S‐wave arrival picking. It has become widely accepted that DL techniques greatly help routine seismic monitoring by enabling more accurate picking than traditional pickers like STA/LTA. However, a completely automatic AI‐driven earthquake monitoring framework has not been reported due to the concerns of potential false positives using DL pickers. Here, we propose a novel AI‐facilitated near real‐time monitoring framework using a recently developed deep learning (DL) picker (EQCCT) that has been deployed in the Texas seismological network (TexNet). For the West Texas area, TexNet's seismic monitoring relies on the EQCCT picker to report earthquake events. For earthquakes with a magnitude above two, the picks are further validated by analysts to output the final TexNet catalog. Due to the fast‐increasing seismicity caused by continuing oil&gas production in West Texas, this AI‐facilitated framework significantly relieves the workload of TexNet analysts. We show the mean absolute error (MAE) of automatic magnitude estimation for the magnitude‐above‐two earthquakes is smaller than 0.15 in West Texas and MAEs of hypocenter locations within 2.6 km in both distance and depth estimates. This research provides more evidence that DL pickers can play a fundamental role in daily earthquake monitoring.

PurposeTo ascertain the relationship between cervical curvature, neck muscle activity and neck disability in patients with chronic nonspecific neck pain (CNNP).MethodsNinety participants (mean age = 27.2, female/male ratio = 7/2) with CNNP volunteered. The Neck Disability Index was used to assess neck disability. To indicate the electromyographic characteristics of the axioscapular muscles, the root mean squares and median frequencies of upper trapezius and levator scapula were used. Cervical curvature was measured with a flexible ruler.ResultsDisability of the neck was significantly correlated with curvature (r = −0.599, p < 0.001), upper trapezius root mean square (RMS) (r = 0.694, p < 0.001) and levator RMS (r = 0.429, p < 0.05). Multiple regression analysis produced a significant predictive equation that could predict disability: 33.224− 0.515 × Curvature + 0.156 × Levator RMS − 0.059 × Upper trapezius median frequency + 0.636 × upper trapezius RMS + 0.020 × levator median frequency, with R2 = 0.622.ConclusionCervical curvature as well as different axioscapular muscle activity were found to be related to level of disability. These findings have implications for clinical management of CNNP.

IntroductionMelons are highly sought after worldwide due to their exquisite and delectable taste. However, the peels of these fruits, which are rich in phytochemicals and sustainable components for innovative culinary formulations, are often discarded as waste.MethodsThis study explored the phytochemistry and valorization of three melon fruit, i.e., canary melon (Cucumis melo, var. Fonzy), watermelon (Citrullus lanatus, var. Augusta), and muskmelon (Cucumis melo, var. Cantaloupe), peels in food applications by incorporating into wheat flour biscuits. Peels of fruits were separated, dried and powders were extracted with 70% ethanol.Results and discussionComparing the muskmelon fruit peel to the peels of the other two fruits, the muskmelon fruit peel had the significantly (p

This study explores the implications of sustainable drone technology on the development of Jordan’s logistics sector through the eco-smart economics lens. Based on in-depth qualitative data drawn from 42 semi-structured interviews conducted in Jordan, the study evaluates drones’ influences on environmental, operational, and economic processes, finding that drone technology has the potential to substantially improve delivery timeframes, diminish carbon emissions, and contribute to the sustainable development agenda. However, the study has also outlined several limitations, such as regulatory, technical, and public concerns, especially related to privacy and security. In this regard, for Jordan to benefit from drones in the logistics sector, policy, technological, and partnership advancements are required. Such changes would ensure that Jordan develops a sustainable, rapid, and efficient logistics sector to strengthen its economy.

Herein, durable multi-functional silk is successfully prepared via in-situ clustering of nanopalladium, under the assistance of infrared irradiation. Whereas, the produced fabric acquired superior antimicrobial, UV-resistance and self-cleaning potentialities. Different instrumental analyses were performed, to reveal that; size average of nanopalladium was ranged in 8.6–21.4 nm. Additionally, increment in the nanopalladium concentration reflected in observable improvement of the mechanical properties, color strength and thermal stability. Yellowish degree was significantly increased from 22.36 for silk finished with 100 ppm of nanopalladium (silk-Pd-1) to 42.52 for silk finished with 300 ppm of nanopalladium (silk-Pd-3). Functional treatment of silk with higher concentrated nanopalladium exhibited the highest microbicide action even after 5 washing cycles, the microbial reduction percentage was evaluated to be 67 %, 65 % & 70 % against “St. Aureus, E. Coli and C. Albicans”, respectively. Ultraviolet protective factor (UPF) was superiorly evaluated for silk-Pd-3 to be 98.1 and 40.4 before and after 5 washing cycles. The aid of nanopalladium for acquiring the prepared silk the self-cleaning property as add-function was approved via kinetic study to show that the prepared fabrics exhibited good self-cleaning character by successive in-clustering of nanopalladium, while, t1/2 for dirt removal was 190.9 min.

Abstract Purpose Hypoalbuminemia and anemia are commonly observed indications for one anastomosis gastric bypass (OAGB) reversal and remain significant concerns following the procedure. Sufficient common channel limb length (CCLL) is crucial to minimize nutritional complications. However, limited literature exists regarding the impact of CCLL on OAGB outcomes. This study aimed to assess the effect of CCLL on weight loss and nutritional status in patients who underwent OAGB. Methods A prospective cohort study was conducted from August 2021 to July 2022, involving 64 patients with a body mass index of 40–50 kg/m2. The standardized length of the biliopancreatic limb (BPLL) for all patients in this study was set at 175 cm. Additionally, the measurement of the common channel limb length (CCLL) was performed consistently by the same surgeon for all included patients. Results The mean age and BMI of the patients were 39.91 ± 10.03 years and 43.13 ± 2.43 kg/m2, respectively, at the time of surgery. There was a statistically significant negative correlation between CCLL and percent total weight loss (%TWL) at the 12-month mark after OAGB (P = 0.02). Hypoalbuminemia was observed in one patient (1.6%), while anemia was present in 17 patients (26.6%) at the one-year follow-up. Statistical analysis revealed no significant difference in the incidence of anemia and hypoalbuminemia between patients with CCLL

Abstract This study investigates the application of cavitation in non-invasive abdominal fat reduction and body contouring, a topic of considerable interest in the medical and aesthetic fields. We explore the potential of cavitation to alter abdominal fat composition and delve into the optimization of fat prediction models using advanced hyperparameter optimization techniques, Hyperopt and Optuna. Our objective is to enhance the predictive accuracy of abdominal fat dynamics post-cavitation treatment. Employing a robust dataset with abdominal fat measurements and cavitation treatment parameters, we evaluate the efficacy of our approach through regression analysis. The performance of Hyperopt and Optuna regression models is assessed using metrics such as mean squared error, mean absolute error, and R-squared score. Our results reveal that both models exhibit strong predictive capabilities, with R-squared scores reaching 94.12% and 94.11% for post-treatment visceral fat, and 71.15% and 70.48% for post-treatment subcutaneous fat predictions, respectively. Additionally, we investigate feature selection techniques to pinpoint critical predictors within the fat prediction models. Techniques including F-value selection, mutual information, recursive feature elimination with logistic regression and random forests, variance thresholding, and feature importance evaluation are utilized. The analysis identifies key features such as BMI, waist circumference, and pretreatment fat levels as significant predictors of post-treatment fat outcomes. Our findings underscore the effectiveness of hyperparameter optimization in refining fat prediction models and offer valuable insights for the advancement of non-invasive fat reduction methods. This research holds important implications for both the scientific community and clinical practitioners, paving the way for improved treatment strategies in the realm of body contouring.

Abstract Background The aggressive nature of Fournier gangrene and the associated health issues can result in a more complex clinical course and potentially a longer hospital stay. This study aimed to assess factors that affect the length of hospital stay (LHS) and its relation to the outcome of Fournier gangrene patients. Methods A retrospective study was performed at King Abdulaziz University Hospital (KAUH), Saudi Arabia, on patients diagnosed with Fournier gangrene between 2017 and 2023. Data about length of hospital stay (LHS), age, BMI, clinical and surgical data and outcome was obtained. Results The mean age of the studied patients was 59.23 ± 11.19 years, the mean body mass index (BMI) was 26.69 ± 7.99 kg/m2, and the mean duration of symptoms was 10.27 ± 9.16 days. The most common presenting symptoms were swelling or induration (64%), 88% had comorbidities with diabetes mellitus (DM) (84%), and 76% had uncontrolled DM. of patients, 24% had a poly-microbial infection, with E. coli being the most common (52%). The mean length of hospital stay (LHS) was 54.56 ± 54.57 days, and 24% of patients had an LHS of more than 50 days. Longer LHS (> 50 days) was associated with patients who did not receive a compatible initial antibiotic, whereas shorter LHS was associated with patients who received Impenem or a combination of vancomycin and meropenem as alternative antibiotics following incompatibility. Reconstruction patients had significantly longer LHS and a higher mean temperature. However, none of the studied variables were found to be predictors of long LHS in the multivariate regression analysis. Conclusion Knowledge of the values that predict LHS allows for patient-centered treatment and may be useful in predicting more radical treatments or the need for additional treatment in high-risk patients. Future multicenter prospective studies with larger sample sizes are needed to assess the needed variables and predictors of long LHS.

Abstract A de-embedding method for determining all scattering (S-) parameters (e.g., characterization) of a sensing area of planar microstrip sensors (two-port network or line) is proposed using measurements of S-parameters with no calibration. The method requires only (partially known) non-reflecting line and reflecting line standards to accomplish such a characterization. It utilizes uncalibrated S-parameter measurements of a reflecting line, direct and reversed configurations of a non-reflecting line, and direct and reversed configurations of the sensing area. As different from previous similar studies, it performs such a characterization without any sign ambiguity. The method is first validated by extracting the S-parameters of a bianisotropic metamaterial slab, as for a two-port network (line), constructed by split-ring-resonators (SRRs) from waveguide measurements. Then, it is applied for determining the S-parameters of a sensing area of a microstrip sensor involving double SRRs next to a microstrip line. The root-mean-square-error (RMSE) analysis was utilized to analyze the accuracy of our method in comparison with other techniques in the literature. It has been observed from such an analysis that our proposed de-embedding technique has the lowest RMSE values for the extracted S-parameters of the sensing area of the designed sensor in comparison with those of the compared other de-embedding techniques in the literature, and have similar RMSE values in reference to those of the thru-reflect-line calibration technique. For example, while RMSE values of real and imaginary parts of the forward reflection S-parameter of this sensing area are, respectively, around 0.0271 and 0.0279 for our de-embedding method, those of one of the compared de-embedding techniques approach as high as 0.0318 and 0.0324.

Background: The study aimed to evaluate musculoskeletal disorder (MSD) prevalence and its correlation with stress in medical students at Umm Al-Qura University (UQU) in Saudi Arabia. Methods: A total of 416 participants participated in this study by answering an online questionnaire. We included medical students from UQU of both genders, ranging from the first year to the sixth year. A questionnaire was used to capture sociodemographic data. The data were collected using the Kessler Psychological Distress Scale (K-10) and Standardized Nordic questionnaire. Results: Among 416 medical students surveyed, 219 (52.60%) were males. A significant proportion of participants, 294 (70.70%), reported experiencing pain during the last 12 months. Female students exhibited significantly higher scores of MSDs compared to their male counterparts. Students who reported working between 51–90 hours per week had a significantly higher MSD score than those who worked 0–50 hours or 91 or more hours. The findings of this study indicated that the most prevalent MSDs were low back pain (50.20%), followed by neck pain (31.70%), and female medical students exhibited significantly higher stress levels than male medical students. Conclusions: Musculoskeletal disorders represent a prevalent health issue among medical students, there is a significant association between factors such as being a female and body mass index. Additionally, psychological stress is a widespread concern among medical students, given the demanding nature of their lifestyle. Interestingly, our findings revealed that there exists a moderately positive relationship between musculoskeletal disorders and stress in this particular population.

BACKGROUND: This study focuses on the development of new approaches to the management of patients with acute decompensation of heart failure (ADHF) using sodium-glucose cotransporter type 2 (iHLT-2) inhibitors, particularly dapagliflozin, and its role in early treatment initiation. AIM: Our aim was to determine the predictors of severe ADHF outcomes in patients with low left ventricular ejection fraction (LVEF) and the role of early initiation of iGLT-2 therapy (within the first 24 h). MATERIALS AND METHODS: This prospective randomized study included a total of 140 patients hospitalized with ADHF between January 1 to September 1, 2023. The patients were randomized into two groups: in group 1, iGLT-2 therapy was started within 24 h from the moment of admission (n=70), and in group 2, standard therapy was implemented (n=70). Hospital data were analyzed. The endpoint was the persistence of congestion in one or both circulatory circuits with New York Heart Association Functional Classes III–IV, indicating severe ADHF. RESULTS: The initial demographic and clinical characteristics of both groups were comparable. In both groups 47% patients did not receive optimal drug therapy (excluding iGLT-2) for chronic heart failure, and no differences were found in this indicator (p=0.081). iGLT-2 therapy did not demonstrate a significant effect on the likelihood of an adverse ADHF outcome (odds ratio [OR]=0.88; 95% confidence interval [CI] 0.43–1.78, p=0.719). Multivariate analysis showed an increase in the probability of this outcome for every 1000 pg/mL increase in N-terminal propeptide of brain natriuretic hormone (NT-proBNP) (OR=1.72, 95% CI 1.37–2.17; p 0.001), blood urea per 1 mmol/L (OR=1.54, 95% CI 1.21–1.97; p=0.001), pulmonary hypertension (OR=7.08, 95% CI 2.15–23.34; p=0.001), and a decrease in the probability of outcome with a 1% increase in LVEF (OR=0.91, 95% CI 0.84–0.99; p=0.031). The sensitivity and specificity of the adverse outcome model were 91.3 and 85.1%, respectively. CONCLUSION: The leading predictors of an unfavorable ADHF outcome include increased levels of NT-proBNP and blood urea, pulmonary hypertension, and decreased LVEF.

Abstract Background The genetic basis of type 2 diabetes (T2D) is under-investigated in the Middle East, despite the rapidly growing disease prevalence. We aimed to define the genetic determinants of T2D in Qatar. Methods Using whole genome sequencing of 11,436 participants (2765 T2D cases and 8671 controls) from the population-based Qatar Biobank (QBB), we conducted a genome-wide association study (GWAS) of T2D with and without body mass index (BMI) adjustment. Results We replicated 93 known T2D-associated loci in a BMI-unadjusted model, while 96 known loci were replicated in a BMI-adjusted model. The effect sizes and allele frequencies of replicated SNPs in the Qatari population generally concurred with those from European populations. We identified a locus specific to our cohort located between the APOBEC3H and CBX7 genes in the BMI-unadjusted model. Also, we performed a transethnic meta-analysis of our cohort with a previous GWAS on T2D in multi-ancestry individuals (180,834 T2D cases and 1,159,055 controls). One locus in DYNC2H1 gene reached genome-wide significance in the meta-analysis. Assessing polygenic risk scores derived from European- and multi-ancestries in the Qatari population showed higher predictive performance of the multi-ancestry panel compared to the European panel. Conclusion Our study provides new insights into the genetic architecture of T2D in a Middle Eastern population and identifies genes that may be explored further for their involvement in T2D pathogenesis.

Abstract Vaginal laxity (VL) is a common condition among multiparous women, especially those who have delivered vaginally. Since pelvic floor muscles (PFMs) work synergistically with other core muscles, physical therapy protocols that aim to treat VL should train the PFMs in combination with other core muscles. To investigate the activity of core muscles in multiparous women with and without VL, and its relation to sexual function. An observational, cross-sectional study. The study included 100 multiparous women, who were divided into two groups according to their scores on the vaginal laxity questionnaire (VLQ). Women who scored between 1 and 3 on the VLQ were categorized as having VL (n = 48), while those who scored between 5 and 7 were placed in the control group (n = 52). The primary outcomes were PFM displacement, diaphragmatic excursion, transversus abdominis activation ratio, and lumbar multifidus thickness measured by ultrasound imaging. The secondary outcome was sexual functioning, evaluated using the Arabic female sexual function index (ArFSFI). The VL group had significantly lower PFM displacement (mean difference (MD) − 0.42; 95% confidence interval (CI) − 0.49 to − 0.33; p = 0.001), diaphragmatic excursion (MD − 2.75; 95% CI − 2.95 to − 2.55; p = 0.001), lumbar multifidus thickness (MD − 10.08; 95% CI − 14.32 to − 5.82; p = 0.02), and ArFSFI scores (MD − 9.2; 95% CI − 10.59 to − 7.81; p = 0.001) in comparison to the control group (p

Abstract A simple and inexpensive microwave measurement setup based on measurements of magnitudes of transmission properties ( $$|S_{21}|_{\text {dB}}$$ | S 21 | dB ) is proposed for industrial-based microwave aquametry (moisture or water content) applications. An easy-to-apply calibration procedure based on normalization is implemented to eliminate systematic errors in the measurement system. As a case study, we applied this setup for the quantification of water-adulteration in flower honey. After validating this system by distilled water and pure flower honey measurements, $$|S_{21}|_{\text {dB}}$$ | S 21 | dB measurements of the pure flower honey with various adulteration percentages ( $$\delta$$ δ ) up to 9% are conducted to examine the performance of the measurement setup for quantification of water adulteration. A multi-dimensional fitting procedure is implemented to predict $$\delta$$ δ using the proposed inexpensive microwave measurement setup. It is shown that it is possible to quantify an adulteration level with an accuracy better than $${\mp } 1$$ ∓ 1 % by the proposed measurement setup and the applied multi-dimensional fitting procedure.

Abstract Background The COVID-19 pandemic has left no one untouched. Resident trainees have been driven to reconsider virtually every component of their daily lives. The purpose of this pilot study is to evaluate the impact of the COVID-19 pandemic on Obstetrics and Gynecology (OBGYN) residency training and education. Methods A cross-sectional pilot study was conducted between 2/2022 and 5/2022. A survey was created and distributed to OBGYN residents. The survey queried the effects of the pandemic on OBGYN residents’ procedure skills training and mental health. Results A total of 95 OBGYN residents across programs affiliated with each American College of Obstetricians and Gynecologists (ACOG) district participated in the survey. Among them, just over half (n = 52, 55%) self-identified as under-represented minorities. A significant majority, 80% (n = 81), felt their gynecological training was inadequate, with 70% of fourth-year residents expressing a lack of confidence in their ability to independently practice gynecology after graduation. This lack of confidence among fourth-year residents suggests a notable disparity in readiness for independent gynecological practice, linked to meeting ACGME requirements before completing their residency (p = 0.013). Among the residents who reported a negative impact of the pandemic on their mental health (n = 76, 80%), about 40% (n = 31) had contemplated self-harm or knew a colleague who considered or attempted suicide (p

Abstract A risk analysis is conducted considering an array of release sources located around the NEOM shoreline. The sources are selected close to the coast and in neighboring regions of high marine traffic. The evolution of oil spills released by these sources is simulated using the MOHID model, driven by validated, high-resolution met-ocean fields of the Red Sea. For each source, simulations are conducted over a 4-week period, starting from first, tenth and twentieth days of each month, covering five consecutive years. A total of 180 simulations are thus conducted for each source location, adequately reflecting the variability of met-ocean conditions in the region. The risk associated with each source is described in terms of amount of oil beached, and by the time required for the spilled oil to reach the NEOM coast, extending from the Gulf of Aqaba in the North to Duba in the South. To further characterize the impact of individual sources, a finer analysis is performed by segmenting the NEOM shoreline, based on important coastal development and installation sites. For each subregion, source and release event considered, a histogram of the amount of volume beached is generated, also classifying individual events in terms of the corresponding arrival times. In addition, for each subregion considered, an inverse analysis is conducted to identify regions of dependence of the cumulative risk, estimated using the collection of all sources and events considered. The transport of oil around the NEOM shorelines is promoted by chaotic circulations and northwest winds in summer, and a dominant cyclonic eddy in winter. Hence, spills originating from release sources located close to the NEOM shorelines are characterized by large monthly variations in arrival times, ranging from less than a week to more than 2 weeks. Similarly, large variations in the volume fraction of beached oil, ranging from less then 50% to more than 80% are reported. The results of this study provide key information regarding the location of dominant oil spill risk sources, the severity of the potential release events, as well as the time frames within which mitigation actions may need to deployed.

Abstract Metasurfaces, promising technology exemplified by their precise manipulation of incident wave properties and exquisite control over electromagnetic field propagation, offer unparalleled benefits when integrated into radar systems, providing higher resolution and increased sensitivity. Here, we introduce a metasurface-enhanced millimeter-wave radar system for advanced near-field bio-sensing, underscoring its adaptability to the skin-device interface, and heightened diagnostic precision in non-invasive healthcare monitoring. The low-profile planar metasurface, featuring a phase-synthesized array for near-field impedance matching, integrates with radar antennas to concentrate absorbed power density within the skin medium while simultaneously improving the received power level, thereby enhancing sensor signal-to-noise ratio. Measurement verification employs a phantom with material properties resembling human skin within the radar frequency range of 58 to 63 GHz. Results demonstrate a notable increase of over 11 dB in near-field Poynting power density within the phantom model, while radar signal processing analysis indicates a commensurate improvement in signal-to-noise ratio, thus facilitating enhanced sensing in biomedical applications.

Abstract Worldwide, stroke is a leading cause of long-term disability in adults. Alteplase is the only approved treatment for acute ischemic stroke (AIS) and results in an improvement in a third of treated patients. We evaluated the post-stroke unfavourable outcome predictors in alteplase-treated patients from Egypt and Saudi Arabia. We assessed the effect of different risk factors on AIS outcomes after alteplase in Egypt and Saudi Arabia. Our study included 592 AIS alteplase-treated patients. The relationship between risk factors, clinical presentation, and imaging features was evaluated to predict factors associated with poor outcomes. An mRS score of three or more was used to define poor outcomes. Poor outcome was seen in 136 patients (23%), and Patients with unfavourable effects had significantly higher admission hyperglycaemia, a higher percentage of diabetes mellitus, cardioembolic stroke, and a lower percentage of small vessel stroke. Patients with higher baseline NIHSS score (OR 1.39; 95% CI 1.12–1.71; P = 0.003), admission hyperglycaemia (OR 13.12; 95% CI 3.37–51.1; P

This research aims to investigate and conduct the impact of earnings management practices on the performance of the banking sector in Jordan. Data were collected from 24 main commercial banks from (2015–2021). The study examine how earnings management practices affect banking sector performance using debt ratios and equity ratios based on firm size and debt ratios, and measure the impact of earnings management on it using regression analysis. The result of the study reveal that a positive and statistically significant association between equity per share (EPS) and return on investment (ROI) with earnings management practices, also, earnings management techniques are positively and significantly impacted by return on equity (ROE), the hypothesis that returns on investment (ROI) encourage business managers to employ earnings management strategies. Also, the study show that dependent variables of earnings management is measured as a debt ratio and equity ratio. Variables that are independent or explanatory of earnings management are considered independent variables.Originality/value – The originality of the study is that it provides evidence about impact of EM practices on banking performance in a developing banking sector.

This literature review offers an extensive exploration of Chaga mushrooms (Inonotus obliquus), focusing on their phytochemical composition, health-promoting attributes, and mechanisms of action. The aim was to provide an up-to-date overview of Chaga's significance in the medicinal sector, emphasizing its potential role in diverse health benefits. The review highlights Chaga's remarkable anticancer, antioxidant, anti-diabetic, anti-inflammatory, antimicrobial, and immunomodulating properties. By synthesizing recent findings, this work underscores Chaga's importance in the medicinal industries and provides valuable insights into its pharmacological potential.

Background Both cancer and cardiovascular disease (CVD) are the leading causes of death worldwide. Although our previous study detected a relationship between CVD and cancer incidence, limited evidence is available regarding the relationship between CVD, cardiovascular risk factors, and cancer mortality. Methods and Results A prospective cohort study using data from the continuous NHANES (National Health and Nutrition Examination Survey, 1999–2016) merged with Medicare and National Death Index mortality data, through December 31, 2018. We included individuals with no history of cancer at baseline. The primary exposure was CVD at baseline. We also conducted a comprehensive risk factor analysis as secondary exposure. The main outcome was cancer mortality data collected from Medicare and National Death Index. We included 44 591 adult individuals representing 1 738 423 317 individuals (52% female, 67% non‐Hispanic White, and 9% Hispanic). Competing risk modeling showed a significantly higher risk of cancer mortality in individuals with CVD (adjusted hazard ratio [aHR], 1.37 [95% CI 1.07–1.76], P=0.01) after adjusting for age, sex, and race and ethnicity. Notably, cancer mortality increased with aging (aHR, 1.08 [95% CI 1.05–1.11], P

The aging process is a multifaceted biological phenomenon characterized by alterations at the molecular, cellular, and organ levels that culminate in a gradual, unavoidable, and unavoidable reduction in the body's capacity to react suitably to internal and/or external stimuli. Aging is a complex process that involves different mechanisms as The "Wear and Tear" Theory ,The Genetic Control Theory ,The Neuroendocrine Theory ,Waste Accumulation Theory ,Divisions Theory, Autoimmune Theory, Thymic-Stimulating Theory ,Mitochondrial Theory Mitochondria, Errors and Repairs Theory, Redundant DNA Theory Cross-Linkage Theory , Death Hormone Theory (DECO), Caloric Restriction Theory ,The Rate of Living Theory ,Gene Mutation Theory, Accumulated mutations Theory, Theory, Order to Disorder Theory, Disposable soma Theory, Antagonistic pleiotropy theory, The Telomerase Theory ,The free radical Theory. The two main categories of aging theories that explain cellular aging are structural damage and programmed theories. Different types of cells experience physiological stressors due to a range of circumstances. Notably, post-mitotic and mitotic cells have different capacities for proliferation and age differently in response to these pressures through different processes of cellular senescence and death, respectively. Over time, these aging cells build up and eventually cause old tissues to malfunction. The aim of this review is to throw light upon the effected of aging and who to treatment it.

Background and purpose: Hair loss is a prevalent problem affecting millions of people worldwide, necessitating innovative and efficient regrowth approaches. Nanostructured lipid carriers (NLCs) have become a hopeful option for transporting bioactive substances to hair follicles because of their compatibility with the body and capability to improve drug absorption. Review approach: Recently, surface modification techniques have been used to enhance hair regeneration by improving the customization of NLCs. These techniques involve applying polymers, incorporating targeting molecules, and modifying the surface charge. Key results: The conversation focuses on how these techniques enhance stability, compatibility with the body, and precise delivery to hair follicles within NLCs. Moreover, it explains how surface-modified NLCs can improve the bioavailability of hair growth-promoting agents like minoxidil and finasteride. Furthermore, information on how surface-modified NLCs interact with hair follicles is given, uncovering their possible uses in treating hair loss conditions. Conclusion: This review discusses the potential of altering the surface of NLCs to customize them for enhanced hair growth. It offers important information for upcoming studies on hair growth.

A comprehensive approach encompassing a blend of spectral techniques and Density Functional Theory (DFT) was employed to elucidate the electronic, vibrational, structural, and nonlinear optical properties of 2,3-dimethyl-N[2-(Hydroxy)benzylidene] aniline (DNHBA). The investigation of this chemical compound involved a meticulous examination using spectroscopic techniques (FTIR, FT-Raman). The DFT calculations utilized the B3LYP method in conjunction with 6-311G (d, p) basis sets. The findings were substantiated by comparing the estimated vibrational frequencies and molecule geometry with experimental data. Using the Time Dependent −Density Functional Theory (TD-DFT) method to calculate the energy band gap of the compound at different solvents. We looked into frontier molecular orbitals (FMO) Molecular electrostatic potential (MEP) and natural bond analysis (NBO) to determine the compound’s kinetic stability and chemical reactivity. Hirshfeld surface (HS) analysis calculated the O–H..O, H-H and intermolecular interaction energy of the compound. The electron density distribution, interactions, and excitation within the title molecule are illustrated by performing topological analyses (RDG, ELF and LOL) using the Multiwfn software. In addition to these assessments, molecular dynamics provides an understanding of the system's dynamic development over a predefined duration during which atoms and molecules are permitted to interact. Utilizing the molecular docking approach allows us to energize the atomic-level interplay between small molecules and proteins within the binding sites of target proteins. This approach enhances our comprehension of vital biochemical processes associated with the behavior of small molecule. The intricacy and hazards associated with drug discovery and development processes have increased dramatically, leading to higher drug research costs.

The dual active bridge (DAB) converter is a versatile DC-DC converter, which has AC components in the high-frequency transformer within the converter topology as well as DC components at the input and output sides. These AC components are constructed from infinite sinusoids of multiples of the converter's switching frequency. Different approaches have been proposed to model the DAB converter. The generalized averaging modeling (GAM) includes only the first order harmonic of the inductor current with the DC components of the input and output voltages and currents. For better model accuracy, harmonic-domain models have been employed, where the model includes all the harmonics of all the model state variables up to an arbitrary harmonic index. While the harmonic model provides a systematic approach to include the harmonics, this increases the model complexity. To avoid this complexity, the flexible harmonic model is used where harmonics can be selected per each state variable without needing to be in successive order. The aforementioned modeling approaches have been implemented on the DAB converter. This paper aims to compare between the dynamic performance of GAM and the harmonic modeling approaches under different disturbances, where the GAM approach provided a simple model with acceptable results that can be used for controller design, while the LTP model provided a more complex model with better accuracy that is suitable for harmonic studies. The models have been validated and compared using simulations executed on MATLAB /Simulink environment.

Insulin resistance (IR) and beta cell dysfunction are the major drivers of type 2 diabetes (T2D). Genome-Wide Association Studies (GWAS) on IR have been predominantly conducted in European populations, while Middle Eastern populations remain largely underrepresented. We conducted a GWAS on the indices of IR (HOMA2-IR) and beta cell function (HOMA2-%B) in 6,217 non-diabetic individuals from the Qatar Biobank (QBB; Discovery cohort; n = 2170, Replication cohort; n = 4047) with and without body mass index (BMI) adjustment. We also developed polygenic scores (PGS) for HOMA2-IR and compared their performance with a previously derived PGS for HOMA-IR (PGS003470). We replicated 11 loci that have been previously associated with HOMA-IR and 24 loci that have been associated with HOMA-%B, at nominal statistical significance. We also identified a novel locus associated with beta cell function near VEGFC gene, tagged by rs61552983 (P = 4.38 × 10-8). Moreover, our best performing PGS (Q-PGS4; Adj R2 = 0.233 ± 0.014; P = 1.55 x 10-3) performed better than PGS003470 (Adj R2 = 0.194 ± 0.014; P = 5.45 x 10-2) in predicting HOMA2-IR in our dataset. This is the first GWAS on HOMA2 and the first GWAS conducted in the Middle East focusing on IR and beta cell function. Herein, we report a novel locus in VEGFC that is implicated in beta cell dysfunction. Inclusion of under-represented populations in GWAS has potentials to provide important insights into the genetic architecture of IR and beta cell function.

Abstract Background A considerable body of research has demonstrated that reducing sitting time benefits health. Therefore, the current study aimed to explore the prevalence of sedentary behavior (SB) and its patterns. Methods A total of 6975 university students (49.1% female) were chosen randomly to participate in a face-to-face interview. The original English version of the sedentary behavior questionnaire (SBQ) was previously translated into Arabic. Then, the validated Arabic version of the SBQ was used to assess SB. The Arabic SBQ included 9 types of SB (watching television, playing computer/video games, sitting while listening to music, sitting and talking on the phone, doing paperwork or office work, sitting and reading, playing a musical instrument, doing arts and crafts, and sitting and driving/riding in a car, bus or train) on weekdays and weekends. Results SBQ indicated that the total time of SB was considerably high (478.75 ± 256.60 and 535.86 ± 316.53 (min/day) during weekdays and weekends, respectively). On average, participants spent the most time during the day doing office/paperwork (item number 4) during weekdays (112.47 ± 111.11 min/day) and weekends (122.05 ± 113.49 min/day), followed by sitting time in transportation (item number 9) during weekdays (78.95 ± 83.25 min/day) and weekends (92.84 ± 100.19 min/day). The average total sitting time of the SBQ was 495.09 ± 247.38 (min/day) and 58.4% of the participants reported a high amount of sitting time (≥ 7 hours/day). Independent t-test showed significant differences (P ≤ 0.05) between males and females in all types of SB except with doing office/paperwork (item number 4). The results also showed that male students have a longer daily sitting time (521.73 ± 236.53 min/day) than females (467.38 ± 255.28 min/day). Finally, 64.1% of the males reported a high amount of sitting time (≥ 7 hours/day) compared to females (52.3%). Conclusion In conclusion, the total mean length of SB in minutes per day for male and female university students was considerably high. About 58% of the population appeared to spend ≥7 h/day sedentary. Male university students are likelier to sit longer than female students. Our findings also indicated that SB and physical activity interventions are needed to raise awareness of the importance of adopting an active lifestyle and reducing sitting time.

Abstract Sparsity finds applications in diverse areas such as statistics, machine learning, and signal processing. Computations over sparse structures are less complex compared to their dense counterparts and need less storage. This paper proposes a heuristic method for retrieving sparse approximate solutions of optimization problems via minimizing the $$\ell _{p}$$ ℓ p quasi-norm, where $$0